Individual
DR. BLAKE BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1700 W KARCHER RD, NAMPA, ID 83651-1531
(208) 449-1058
Mailing address
3848 E TALON CIR, IDAHO FALLS, ID 83401-1215
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100443
ID
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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